The ROI behind Efficient Facility Design - William F. (Bud) Barrow, II & R. Wayne Estopinal
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For more information contact: Slideshare@marcusevans.com Presentation by R. Wayne Estopinal, AIA, ACHA, LEED AP, President, TEG Architects, LLC and William F. (Bud) Barrow, II, President and Chief Executive Officer, Our Lady of Lourdes Regional Medical Center, Inc. at the marcus evans National Healthcare CXO Summit Spring 2015 in FL.
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The ROI behind Efficient Facility Design - William F. (Bud) Barrow, II & R. Wayne Estopinal
- 1. VOLUME 5: RETURN ON INVESTMENT OF FACILITY DESIGN 18 MAY 2015 | DECISION PROCESS = CLINICAL AND FINANCIAL RESULTS
- 2. 2 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Introductions TEG Efficient Design+Productive Care Clinical Procedural Platform • Overview • Platform Design Elements TEG Efficient Design+Productive Care Decision Management Timeline Clinical Procedural Platform Concept Benefits and ROI Impact • Clinical Volumes Comparison • Staffing Comparison • Patient Satisfaction Comparison • Financial Results Comparison Questions from Attendees Presentation Outline Return on Investment of Facility Design 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0
- 3. 3 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Introductions R. Wayne Estopinal AIA, ACHA, LEED AP President TEG Architects W. F. “Bud” Barrow, II AHA Region 7 Policy Board Chair, AHA Board Member President/CEO Our Lady of Lourdes Regional Medical Center
- 4. 4 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Our Lady of Lourdes Regional Medical Center (OLOL) Lafayette, Louisiana Process = Results Replacement Facility Metrics • Total Acute SF 430,400 • Number of Beds 186 • SF/Bed 2,314 • Percent Circulation 10.2% • Site Acreage 46
- 5. 5 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Clinical Procedural Platform • Overview • Platform Design Elements
- 6. 6 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Clinical Procedural Platform Overview Departments Involved • Emergency • Imaging • Invasive Cardiology • Surgery • Surgical Prep/Recovery and PACU • Innovative Area - Flex Unit DECON DECON DECON EMERGENCY IMAGING FLEX UNIT CYSTO GI CATH SURGERY CARDIOLOGY PRE/POST OP PACU
- 7. 7 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Clinical Procedural Platform Design Elements Circulation • Corridors Clear and Direct • Staff Functions Without Circuitous Routes • Reduces Travel Distances
- 8. 8 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Departmental Adjacencies • Department Locations with Direct Access to Other Departments • Clinical Frequencies Determines Adjacencies Clinical Procedural Platform Design Elements
- 9. 9 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Visibility • Staff Stations Allow Viewing of Multiple Patient Care Areas • Reduces Need for Staffing Observation Stations Photo by: Will Crocker Clinical Procedural Platform Design Elements
- 10. 10 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Expandability • Horizontal Expansion via Exterior Walls • Eliminates Major Disruption or Demolition of Clinical Spaces Clinical Procedural Platform Design Elements
- 11. 11 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 • Circulation • Departmental Adjacencies • Visibility • Expandability Clinical Procedural Platform Summary
- 12. 12 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Decision Management Timeline 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0
- 13. 13 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Project Decision Management Timeline Overview Objective: Continuation of services to insure maximum value is provided to the Hospital. 8.0 CONSTRUCTION 9.0 POST CONSTRUCTION 1.0 INVESTIGATE/CONFIRM/VISION/INFORM Objective: Explore new ideas and Confirm prior decisions; Inform/Educate Hospital participants. Guiding Principles Draft One. 2.0 PROGRAM Objective: Define facility square footages driven by projected clinical utilization data./Service Lines/Programs and Departments 3.0 CONCEPTUAL Objective: Create departmental level images to optimize clinical efficiency and illustrate adjacencies./Resolve Guiding Principles 4.0 SCHEMATIC DESIGN Objective: Design spatially accurate images to define the project./Initial Facility Aesthetics 5.0 DESIGN DEVELOPMENT Objective: Detail each space via clinical collaboration and multi-disciplinary input. Objective: Deliver the facility by collaboration with Construction Team. 7.0 BIDDING/NEGOTIATIONS Objective: Price the CD Package via selected construction delivery process. 6.0 CONSTRUCTION DOCUMENTS Objective: Document the Replacement Hospital via construction level detailing and coordination.
- 14. 14 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 OLOL Collaboration Metrics • 170 Meetings between OLOL & TEG • 105 OLOL Staff Involved • 28 Design Team Members • 104,051 Design Team Hours OLOL Nurses Station 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 Project Decision Management Timeline Overview
- 15. 15 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Project Decision Management Timeline Overview A. Hospital .01 Leadership Team .02 Project Committee .03 Buildings/Equipment Committee .04 Board of Directors .05 Departmental Leaders .06 Physician Leaders B. Design Team .01 Architects .02 Civil Engineering .03 Structural Engineering .04 Mechanical/Electrical Engineering .05 Code/Egress Consultant .06 Landscape Architect .07 Interior Design Sample list of Participants 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 C. Construction Team .01 Construction Manager .02 Prime Sub Contractors D. Consultants .01 Health Care Delivery Strategist .02 Program Manager .03 Equipment Planner .04 Construction Cost Estimator .05 Transition/Move Consultants .06 Security Consultant .07 Information Technology Consultant .08 Legal Counsel/Construction Specialist .09 Financial Consultant .10 Vertical Transportation Consultant .11 Traffic Consultant OLOL Lobby Interior
- 16. 16 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Clinical Procedural Platform Concept Benefits and ROI Impact • Clinical Volumes Comparison • Staffing Comparison • Patient Satisfaction Comparison • Financial Results Comparison
- 17. 17 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Clinical Volume Comparison FY 2011 vs. FY 2014 FY 2011: 29,096 FY 2014: 36,081 FY 2011: 6,549 FY 2014: 6,757 FY 2011: 52,246 FY 2014: 75,175 24% Increase 3.17% Increase* 43.88% Increase * Surgical Volumes are reduced due to joint venture with adjoining surgical hospital on campus Emergency Department Visits Surgical Department Procedures Imaging Department Procedures
- 18. 18 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Staffing to Clinical Volume Comparison Emergency Department Old Campus 43.1 FTE Utilization: 675 Visits/FTE New Campus 49.4 FTE Utilization: 730 Visits/FTE Surgical Department Old Campus 45.9 FTE Utilization: 143 Procedures/FTE New Campus 52.2 FTE* Utilization: 130 Procedures/FTE Imaging Department Old Campus 25.8 FTE Utilization: 2,025 Procedures/FTE New Campus 34.2 FTE Utilization: 2,199 Procedures/FTE 14.61% Staffing Increase 13.72% Staffing Increase* 32.55% Staffing Increase *Actual staffing increases were minimal given the percentage of procedure increases documented. Surgery procedures did not increase significantly due to the surgical hospital joint venture with physicians.
- 19. 19 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Goals • Not Reduce Staffing • Create Facility that Attracts Greater Market Share • Improves Outcomes and Access to Care • Department Size Based on Need • Staff Productivity Improved • Financial Results Improved Staffing to Clinical Volume Comparison 3.17%* Procedure Increase 13.72% Staffing Increase 24% Visit Increase 14.61% Staffing Increase 43.88% Procedure Increase 32.55% Staffing Increase *Actual staffing increases were minimal given the percentage of procedure increases documented. Surgery procedures did not increase significantly due to the surgical hospital joint venture with physicians.
- 20. 20 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Patient Satisfaction Comparison Press Ganey Guardian of Excellence Award OLOL named a Guardian of Excellence Award winner by Press Ganey Associates, Inc in 2013 and 2014 86th Percentile of Scoring Population Press Ganey Mean Scores: Old Campus VS. New Campus Comparison 60th Percentile of Scoring Population 86.7 Old Campus Press Ganey Mean Score 89.7 New Campus Press Ganey Mean Score 3.0 Increase OLOL Patient Room Photo by: Will Crocker
- 21. 21 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 OLOL Overall Facility Performance FY 2011: $155,818,000 FY 2014: $192,540,000 23.57% Increase Net Patient Service Revenue 2011 vs. 2014 OLOL Hybrid OR
- 22. 22 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Financial Results Emergency Department $2,160,314 Increase FY 2011: $(71,912) FY 2014: $2,088,402 Net Profit 8% Decrease FY 2014: $3,310,259 FY 2011: $3,605,999 Total Salaries/Wages/Benefits DECON Total Gross Revenue 89% Increase Net Revenue 71% Increase EMERGENCY
- 23. 23 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Net Revenue 49% Increase Total Gross Revenue 58% Increase $1,495,340 Increase FY 2011: $(1,288,514) FY 2014: $206,826 Net Profit 6% Decrease FY 2014: $3,314,931 FY 2011: $3,532,222 Total Salaries/Wages/Benefits SURGICAL Financial Results Surgical Department
- 24. 24 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 $2,634,602 Increase FY 2011: $3,674,925 FY 2014: $6,309,527 Net Profit 17% Increase FY 2014: $2,439,680 FY 2011: $2,085,806 Total Salaries/Wages/Benefits Total Gross Revenue 73% Increase Net Revenue 43% Increase IMAGING Financial Results Imaging Department
- 25. 25 NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015 Series Volume III Masterplanning Aligned Planning Strategies & Collaborative Visioning Volume II ED Examples Emergency Departments: Highly Efficient Facility Design Volume I ED Efficiency Emergency Departments: Facility Metrics with Time & Motion Considerations 2012 | VOLUME. 03 | A PrOcEss OF highLy EFFiciEnt FAciLity dEsign EFFICIENT DESIGN PRODUCTIVE CARE ALIGNED PLANNING STRATEGIES AND COLLABORATIVE VISIONING 2011 | VOLUME. 02 | A CASE STUDY OF HIGHLY EFFICIENT FACILITY DESIGN EFFICIENT DESIGN PRODUCTIVE CARE DESIGNING EMERGENCY DEPARTMENTS THAT IMPROVE STAFF PRODUCTIVITY 1 Efficient Design Productive Care Designing Emergency Departments that Improve Staff Productivity A case study of facility metrics with time and motion considerations. 2010 + VOLUME 5: RETURN ON INVESTMENT OF FACILITY DESIGN 2015 | VOLUME .05 | DECISION PROCESS = CLINICAL AND FINANCIAL RESULTS Volume IV Nursing Units High Performance Nursing Units & Patient Room Innovation Volume V ROI of Facility Design Decision process = Clinical and Financial results